Unilateral Absence of the Soft Palate: Case Report of Reconstruction with a Mucoperiosteal Island Flap

1993 ◽  
Vol 30 (5) ◽  
pp. 497-499 ◽  
Author(s):  
M. Emin Mavili ◽  
Tacettin Gucer ◽  
Yucel Erk
Keyword(s):  
Case Report ◽  
Cleft Palate ◽  
Soft Palate ◽  
Speech Quality ◽  
Island Flap ◽  
Velopharyngeal Insufficiency ◽  
Congenital Absence

Congenital absence of half of the soft palate Is a rare deformity. There is little in the literature about its definition and management. This article presents a case with velopharyngeal insufficiency caused by unilateral absence of the soft palate. The patient was treated with a modification of the mucoperiosteal Island flap, first designed by Millard, to provide nasal lining during pushback lengthening of a short cleft palate. The speech quality of the patient Improved noticeably after the operation. Although island flap has limited use in primary cleft palate surgery, It may be effective in reconstruction of soft palate defects, when standard pushback procedures are not adequate for solving the problem.

scholarly journals Case report on bilateral cleft palate with protuded premaxilla

2022 ◽  
Vol 4 (4) ◽  
pp. 154-157
Author(s):  
Priyanka Kosare ◽  
Pallavi Madanrao Bobade
Keyword(s):  
Case Report ◽  
Cleft Palate ◽  
Soft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Bilateral Cleft Lip ◽  
Icd 10

Cleft palate (ICD 10-Q 35.9) with Protruding of premaxilla is common feature in patient with bilateral cleft lip and palate it is due to the under trained growth at anterior nasal septal and vomero-premaxillary suture without lateral continuities. Hippocrates (400BC) AND Galen(150AD) mansion cleft lip, but not cleft palate in their writing, Cleft palate –Fanco.(1556), Repair of cleft lip –as early as 255-206 BC in CHINA. The first successful closure of a soft palate defect was reported in 1764 by LEMONNIERa French dentist.

Morphologic Significance of Bifid Uvula

PEDIATRICS ◽  
1985 ◽  
Vol 75 (3) ◽  
pp. 553-561
Author(s):  
Robert J. Shprintzen ◽  
Richard H. Schwartz ◽  
Avron Daniller ◽  
Lynn Hoch
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Hard Palate ◽  
Velopharyngeal Insufficiency ◽  
Pediatric Practice ◽  
Submucous Cleft Palate ◽  
Hypernasal Speech ◽  
Definition Of

Bifid uvula is often regarded as a marker for submucous cleft palate although this relationship has not been fully confirmed. The reason for the tacitly assumed connection between these two anomalies has, in part, been perpetuated by the generally accepted definition of submucous cleft palate as the triad of bifid uvula, notching of the hard palate, and muscular diastasis of the soft palate. Recently, investigations have provided evidence of more subtle manifestations of submucous cleft palate by the use of nasopharyngoscopic examination of the palate and pharynx. It has been determined that submucous cleft palate can occur even when a peroral examination shows an intact uvula. This finding places the "marker" relationship in question. In order to determine the frequency of association between bifid uvula and submucous clefting, a total ascertainment of children with bifid uvula from a suburban pediatric practice was examined nasopharyngoscopically. It was determined that in all but two cases, children with bifid uvula had some or all of the landmarks of submucous cleft palate. Several of the children were found to have velopharyngeal insufficiency and mildly hypernasal speech. This finding prompts caution in the recommendation of adenoidectomy in the presence of bifid uvula.

scholarly journals Meatus obturator-a treatment of choice in managing Velopharyngeal defect-a case report

2018 ◽  
Vol 9 (6) ◽  
pp. 539-542
Author(s):  
Anulekha CK ◽  
Hari priya ◽  
Taruna M ◽  
Chittaranjan B ◽  
Parameshwari B
Keyword(s):  
Case Report ◽  
Soft Palate ◽  
Velopharyngeal Insufficiency ◽  
The Novel ◽  
Sensitive Issue ◽  
Novel Approach ◽  
Palatal Defect

Defects related to Velopharyngeal insufficiency has always been a critical and sensitive issue to manage as it requires rehabilitation of the palatal defect along with maintaining the integrity of speech, mastication and esthetics. The primary goal of prosthodontist in each case is to construct a prosthesis, which will restore the defect, improve Esthetics and thereby benefit the morale of patient. In case of completely edentulous maxilla with the defect involving the hard and soft palate, Meatus obturator plays an important role by contributing to retention and stability of the prosthesis by engaging the posterior nasal undercuts. This case report describes the novel approach to fabricate Meatus obturator for a patient suffering from Velopharyngeal insufficiency.

scholarly journals Incidence of Speech-Correcting Surgery in Children With Isolated Cleft Palate

2018 ◽  
Vol 55 (8) ◽  
pp. 1115-1121 ◽  
Author(s):  
Charlotta Gustafsson ◽  
Arja Heliövaara ◽  
Junnu Leikola ◽  
Jorma Rautio
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
University Hospital ◽  
Velopharyngeal Insufficiency ◽  
Fistula Repair ◽  
Repair Rate ◽  
Medical Chart Review ◽  
Before School ◽  
Long Term Observation ◽  
Isolated Cleft Palate

Objective: Speech-correcting surgeries (pharyngoplasty) are performed to correct velopharyngeal insufficiency (VPI). This study aimed to analyze the need for speech-correcting surgery in children with isolated cleft palate (ICP) and to determine differences among cleft extent, gender, and primary technique used. In addition, we assessed the timing and number of secondary procedures performed and the incidence of operated fistulas. Design: Retrospective medical chart review study from hospital archives and electronic records. Participants: These comprised the 423 consecutive nonsyndromic children (157 males and 266 females) with ICP treated at the Cleft Palate and Craniofacial Center of Helsinki University Hospital during 1990 to 2016. Results: The total incidence of VPI surgery was 33.3% and the fistula repair rate, 7.8%. Children with cleft of both the hard and soft palate (n = 300) had a VPI secondary surgery rate of 37.3% (fistula repair rate 10.7%), whereas children with only cleft of the soft palate (n = 123) had a corresponding rate of 23.6% (fistula repair rate 0.8%). Gender and primary palatoplasty technique were not considered significant factors in need for VPI surgery. The majority of VPI surgeries were performed before school age. One fifth of patients receiving speech-correcting surgery had more than one subsequent procedure. Conclusion: The need for speech-correcting surgery and fistula repair was related to the severity of the cleft. Although the majority of the corrective surgeries were done before the age of 7 years, a considerable number were performed at a later stage, necessitating long-term observation.

Comparing Quality of Life and Perceptual Speech Ratings in Children With Cleft Palate

2020 ◽  
pp. 105566562094943
Author(s):  
Hailey M. Pedersen ◽  
Paige A. Goodie ◽  
Maia N. Braden ◽  
Susan L. Thibeault
Keyword(s):  
Quality Of Life ◽  
Cleft Palate ◽  
Population Based ◽  
Velopharyngeal Insufficiency ◽  
Average Score ◽  
Life Outcomes ◽  
Speech Language Pathologist ◽  
Perceptual Characteristics ◽  
Velopharyngeal Function

Objective: To delineate the relationship between patient and parent-reported quality of life (QOL) ratings and perceptual characteristics of speech assigned by a speech-language pathologist (SLP) in children with repaired cleft palate. Design: Prospective. Setting: Academic Children’s Hospital. Participants: This population-based sample included children, aged 3 to 18 with a history of repaired cleft palate, and their parents. Intervention: Participants completed the Velopharyngeal Insufficiency Effects on Life Outcomes Questionnaire (VELO). Children’s speech was judged perceptually by an expert SLP using the Pittsburgh Weighted Speech Scale (PWSS). Main Outcome Measure(s): Velopharyngeal Insufficiency Effects on Life Outcomes questionnaire assessed participant and parent perceptions of impact of velopharyngeal function on QOL. Pittsburgh Weighted Speech Scale assessed nasal emissions, facial grimacing, nasality, quality of phonation, and articulation. Results: Enrollment included 48 participant parent dyads. Overall, participants reported high QOL scores within the 95% CI with children reporting slightly better yet not significantly different QOL (86.27 ± 8.96) compared to their parents (81.81 ± 15.2). Children received an average score of 1.38 ± 1.96 on the PWSS corresponding to borderline velopharyngeal competence. A significant moderate negative correlation was found between PWSS total score and parent VELO total score (r = −0.51103, P = .0002). Mild–moderate significant negative correlations were measured between PWSS total and the 5 subscales of the VELO. No significant correlations were measured between PWSS and child VELO total responses or between total scores and subscales. Conclusions: Results suggest that as perceptual analysis of speech improves, overall QOL improves moderately.

Morphological Characterization of the Levator Veli Palatini Muscle in Children Born with Cleft Palates

2001 ◽  
Vol 38 (5) ◽  
pp. 438-448 ◽  
Author(s):  
Rolf Lindman ◽  
Gunnar Paulin ◽  
Per S. Stål
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Surgical Repair ◽  
Fiber Type ◽  
Muscle Spindles ◽  
Morphological Characterization ◽  
Velopharyngeal Insufficiency ◽  
Normal Adult ◽  
Levator Veli Palatini

Objective: The aim of this study was to analyze, morphologically and biochemically, one of the soft palate muscles, the levator veli palatini (LVP), in children born with cleft palate. Subjects and Methods: Biopsies were obtained from nine male and three female infants in connection with the early surgical repair of the hard and soft palate. Samples from five adult normal LVP muscles were used for comparison. The muscle morphology, fiber type and myosin heavy chain (MyHC) compositions, capillary supply, and content of muscle spindles were analyzed with different enzyme-histochemical, immunohistochemical, and biochemical techniques. Results: Compared with the normal adult subjects, the LVP muscle from the infantile subjects with cleft had a smaller mean fiber diameter, a larger variability in fiber size and form, a higher proportion of type II fibers, a higher amount of fast MyHCs, and a lower density of capillaries. No muscle spindles were observed. Moreover, one-third of the biopsies from the infantile subjects with cleft LVP either lacked muscle tissue or contained only a small amount. Conclusions: The LVP muscle from children with cleft palate has a different morphology, compared with the normal adult muscle. The differences might be related to different stages in maturation of the muscles, changes in functional demands with growth and age, or a consequence of the cleft. The lack of contractile tissue in some of the cleft biopsies offers one possible explanation to a persistent postsurgical velopharyngeal insufficiency in some patients, despite a successful surgical repair.

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